Long-term followup and deterioration rate of anterior substitution urethroplasty

Guido Barbagli, Sanjay B. Kulkarni, Nicola Fossati, Alessandro Larcher, Salvatore Sansalone, Giorgio Guazzoni, Giuseppe Romano, Joshi M. Pankaj, Vincenzo Dell'Acqua, Massimo Lazzeri

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Purpose We investigated deterioration of the success rate of penile and bulbar substitution urethroplasty. Materials and Methods We performed a retrospective descriptive analysis of patients who underwent substitution urethroplasty between July 1994 and September 2007. Inclusion criteria included 1-stage anterior urethroplasty using penile skin or oral mucosa with a minimum of 6 years followup. Patients with posterior urethral stricture, failed hypospadias or incomplete clinical records were excluded from analysis. The primary study outcome was postoperative failure-free survival and the secondary outcome was to identify significant predictors of treatment failure. The clinical outcome was considered a failure when any postoperative instrumentation was needed. Descriptive statistical analysis was done as well as Kaplan-Meier analysis, and univariable and multivariable Cox regression analysis. Results A total of 359 patients were included in study. Median followup was 118 months. Of the procedures 265 (73.8%) were successful and 94 (26.2%) failed, including 91 (96.8%) within the first 5 years. Substitute tissue type (oral mucosa vs skin) was the only significant predictor on univariable analysis (HR 1.86, p = 0.005). This result was confirmed by multivariable analysis adjusting for age at surgery, stricture length and etiology, urethroplasty type and previous treatments (HR 2.26, p = 0.001). Conclusions Deterioration after anterior 1-stage substitution urethroplasty seems to develop within the first 5 years. Oral mucosa showed greater failure-free survival than penile skin and 1-stage penile urethroplasty showed the same success rate as bulbar urethroplasty.

Original languageEnglish
Pages (from-to)808-813
Number of pages6
JournalJournal of Urology
Volume192
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Mouth Mucosa
Skin
Urethral Stricture
Hypospadias
Survival
Kaplan-Meier Estimate
Treatment Failure
Pathologic Constriction
Regression Analysis
Outcome Assessment (Health Care)
Therapeutics

Keywords

  • patient outcome assessment
  • reconstructive surgical procedures
  • transplants
  • treatment failure
  • urethra

ASJC Scopus subject areas

  • Urology

Cite this

Barbagli, G., Kulkarni, S. B., Fossati, N., Larcher, A., Sansalone, S., Guazzoni, G., ... Lazzeri, M. (2014). Long-term followup and deterioration rate of anterior substitution urethroplasty. Journal of Urology, 192(3), 808-813. https://doi.org/10.1016/j.juro.2014.02.038

Long-term followup and deterioration rate of anterior substitution urethroplasty. / Barbagli, Guido; Kulkarni, Sanjay B.; Fossati, Nicola; Larcher, Alessandro; Sansalone, Salvatore; Guazzoni, Giorgio; Romano, Giuseppe; Pankaj, Joshi M.; Dell'Acqua, Vincenzo; Lazzeri, Massimo.

In: Journal of Urology, Vol. 192, No. 3, 2014, p. 808-813.

Research output: Contribution to journalArticle

Barbagli, G, Kulkarni, SB, Fossati, N, Larcher, A, Sansalone, S, Guazzoni, G, Romano, G, Pankaj, JM, Dell'Acqua, V & Lazzeri, M 2014, 'Long-term followup and deterioration rate of anterior substitution urethroplasty', Journal of Urology, vol. 192, no. 3, pp. 808-813. https://doi.org/10.1016/j.juro.2014.02.038
Barbagli G, Kulkarni SB, Fossati N, Larcher A, Sansalone S, Guazzoni G et al. Long-term followup and deterioration rate of anterior substitution urethroplasty. Journal of Urology. 2014;192(3):808-813. https://doi.org/10.1016/j.juro.2014.02.038
Barbagli, Guido ; Kulkarni, Sanjay B. ; Fossati, Nicola ; Larcher, Alessandro ; Sansalone, Salvatore ; Guazzoni, Giorgio ; Romano, Giuseppe ; Pankaj, Joshi M. ; Dell'Acqua, Vincenzo ; Lazzeri, Massimo. / Long-term followup and deterioration rate of anterior substitution urethroplasty. In: Journal of Urology. 2014 ; Vol. 192, No. 3. pp. 808-813.
@article{faaa384e11cf4cb48c0e3c8edd62b0c2,
title = "Long-term followup and deterioration rate of anterior substitution urethroplasty",
abstract = "Purpose We investigated deterioration of the success rate of penile and bulbar substitution urethroplasty. Materials and Methods We performed a retrospective descriptive analysis of patients who underwent substitution urethroplasty between July 1994 and September 2007. Inclusion criteria included 1-stage anterior urethroplasty using penile skin or oral mucosa with a minimum of 6 years followup. Patients with posterior urethral stricture, failed hypospadias or incomplete clinical records were excluded from analysis. The primary study outcome was postoperative failure-free survival and the secondary outcome was to identify significant predictors of treatment failure. The clinical outcome was considered a failure when any postoperative instrumentation was needed. Descriptive statistical analysis was done as well as Kaplan-Meier analysis, and univariable and multivariable Cox regression analysis. Results A total of 359 patients were included in study. Median followup was 118 months. Of the procedures 265 (73.8{\%}) were successful and 94 (26.2{\%}) failed, including 91 (96.8{\%}) within the first 5 years. Substitute tissue type (oral mucosa vs skin) was the only significant predictor on univariable analysis (HR 1.86, p = 0.005). This result was confirmed by multivariable analysis adjusting for age at surgery, stricture length and etiology, urethroplasty type and previous treatments (HR 2.26, p = 0.001). Conclusions Deterioration after anterior 1-stage substitution urethroplasty seems to develop within the first 5 years. Oral mucosa showed greater failure-free survival than penile skin and 1-stage penile urethroplasty showed the same success rate as bulbar urethroplasty.",
keywords = "patient outcome assessment, reconstructive surgical procedures, transplants, treatment failure, urethra",
author = "Guido Barbagli and Kulkarni, {Sanjay B.} and Nicola Fossati and Alessandro Larcher and Salvatore Sansalone and Giorgio Guazzoni and Giuseppe Romano and Pankaj, {Joshi M.} and Vincenzo Dell'Acqua and Massimo Lazzeri",
year = "2014",
doi = "10.1016/j.juro.2014.02.038",
language = "English",
volume = "192",
pages = "808--813",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Long-term followup and deterioration rate of anterior substitution urethroplasty

AU - Barbagli, Guido

AU - Kulkarni, Sanjay B.

AU - Fossati, Nicola

AU - Larcher, Alessandro

AU - Sansalone, Salvatore

AU - Guazzoni, Giorgio

AU - Romano, Giuseppe

AU - Pankaj, Joshi M.

AU - Dell'Acqua, Vincenzo

AU - Lazzeri, Massimo

PY - 2014

Y1 - 2014

N2 - Purpose We investigated deterioration of the success rate of penile and bulbar substitution urethroplasty. Materials and Methods We performed a retrospective descriptive analysis of patients who underwent substitution urethroplasty between July 1994 and September 2007. Inclusion criteria included 1-stage anterior urethroplasty using penile skin or oral mucosa with a minimum of 6 years followup. Patients with posterior urethral stricture, failed hypospadias or incomplete clinical records were excluded from analysis. The primary study outcome was postoperative failure-free survival and the secondary outcome was to identify significant predictors of treatment failure. The clinical outcome was considered a failure when any postoperative instrumentation was needed. Descriptive statistical analysis was done as well as Kaplan-Meier analysis, and univariable and multivariable Cox regression analysis. Results A total of 359 patients were included in study. Median followup was 118 months. Of the procedures 265 (73.8%) were successful and 94 (26.2%) failed, including 91 (96.8%) within the first 5 years. Substitute tissue type (oral mucosa vs skin) was the only significant predictor on univariable analysis (HR 1.86, p = 0.005). This result was confirmed by multivariable analysis adjusting for age at surgery, stricture length and etiology, urethroplasty type and previous treatments (HR 2.26, p = 0.001). Conclusions Deterioration after anterior 1-stage substitution urethroplasty seems to develop within the first 5 years. Oral mucosa showed greater failure-free survival than penile skin and 1-stage penile urethroplasty showed the same success rate as bulbar urethroplasty.

AB - Purpose We investigated deterioration of the success rate of penile and bulbar substitution urethroplasty. Materials and Methods We performed a retrospective descriptive analysis of patients who underwent substitution urethroplasty between July 1994 and September 2007. Inclusion criteria included 1-stage anterior urethroplasty using penile skin or oral mucosa with a minimum of 6 years followup. Patients with posterior urethral stricture, failed hypospadias or incomplete clinical records were excluded from analysis. The primary study outcome was postoperative failure-free survival and the secondary outcome was to identify significant predictors of treatment failure. The clinical outcome was considered a failure when any postoperative instrumentation was needed. Descriptive statistical analysis was done as well as Kaplan-Meier analysis, and univariable and multivariable Cox regression analysis. Results A total of 359 patients were included in study. Median followup was 118 months. Of the procedures 265 (73.8%) were successful and 94 (26.2%) failed, including 91 (96.8%) within the first 5 years. Substitute tissue type (oral mucosa vs skin) was the only significant predictor on univariable analysis (HR 1.86, p = 0.005). This result was confirmed by multivariable analysis adjusting for age at surgery, stricture length and etiology, urethroplasty type and previous treatments (HR 2.26, p = 0.001). Conclusions Deterioration after anterior 1-stage substitution urethroplasty seems to develop within the first 5 years. Oral mucosa showed greater failure-free survival than penile skin and 1-stage penile urethroplasty showed the same success rate as bulbar urethroplasty.

KW - patient outcome assessment

KW - reconstructive surgical procedures

KW - transplants

KW - treatment failure

KW - urethra

UR - http://www.scopus.com/inward/record.url?scp=84906100205&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906100205&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2014.02.038

DO - 10.1016/j.juro.2014.02.038

M3 - Article

C2 - 24533999

AN - SCOPUS:84906100205

VL - 192

SP - 808

EP - 813

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3

ER -